Friday, May 27, 2016

If You're Taking an Antidepressant for a Reason Besides Depression, You Should Read This

One in 10 Americans is taking an antidepressant, according to the latest stats from The Centers for Disease Control and Prevention. But a new study suggests that depression may not be the only reason: Doctors are increasingly doling out prescriptions for antidepressants to treat other conditions—from sexual dysfunction to eating disorders—according to the research published in the journal JAMA.

The study analyzed more than 100,000 prescriptions for antidepressantswritten by 158 doctors in Quebec over the last decade. Of those scripts, 44.8% were written to treat a disorder that was not depression. And 29.4% of the drugs were given for an off-label indication. (For the purposes of this study, that meant the drug had not been approved by the FDA or Health Canada to treat the condition in question.)

The researchers found that many of the off-label scripts were for insomnia (10.2%) and pain (6.1%). But doctors were also prescribing antidepressants for migraines, ADHD, digestive system disorders, and symptoms of menopause.

“The problem isn’t with off-label [use] in general,“ says study co-author Jenna Wong, a PhD candidate at McGill University in Montreal. "For some antidepressants there is good documented research to show they can treat certain conditions. But there’s a problem when medications are used off label with no scientific evidence at all.”

She points out that when your MD prescribes a drug, you assume it has been approved as a treatment—in other words, that it’s been through a regulatory process designed to help keep you safe. But clearly that’s not always the case.

An off-label treatment might not be inherently bad, but it does open you up to side effects—and it may not even help you feel better, says Wong.

“For so many of these conditions, there aren’t really great medications known to be effective,” says Wu. "If a patient asks their doctor for something to relieve their symptoms, and are given an antidepressant, they should be aware that it may be off label.”

The takeaway? It’s important to be involved in your care—even when you’re understandably eager to find a cure for what ails you. That doesn’t mean you need to dig into the scientific literature yourself. But ask your doctor questions—like why an antidepressant might be appropriate, what the research says about it. It’s up to doctors to scrutinize that kind of information, says Wong. Then, discuss the pros and cons of the drug with your provider. The technical term is “shared decision making,” and the idea is that together, you and your doc can come up with a plan that’s right for you.